A few years ago, I reconnected with college friend Maura Flanagan, and I learned how a diagnosis of Type 2 diabetes in 2005 motivated her to enroll in a clinic-based program that led to a weight loss of almost 100 pounds in less than a year. Maura’s success is in part due to on-going support from the staff at the National Center for Weight and Wellness and in equal part, it seems to me, to her willingness to experiment. Giving up the old ways – of thinking, eating, and socializing – take creativity and persistence. Maura has kept the weight off for more than eight years.

In a long phone interview about the changes to her health and her life, Maura reflected on her approach and shared insights for others who are contemplating health challenges.

New activities for momentum and reward

As Maura began to lose weight, she realized she needed to add new activities into her life to help her maintain momentum for the health changes she was making. Her practice of meditation was the first new experience she tried (see part one). Meditation has helped her relax, lessen the effects of neuropathy, and mitigate the “negative self talk,” as she called it, associated with coping with health problems.

Maura tries many new activities as rewards, and she attempts to do a new one each month. Although many of them seem fun or simply enjoyable on the surface, they can also be intimidating. For example, Maura had her first manicure after weight loss. She explains that it wasn’t easy for her, even though it may be “a simple thing” for many adults. Her awareness of neuropathy and her hands heightened her concerns about hygiene and infection. She wondered: would it be painful? Maura told me that she enjoyed it and, “I now do it every once in a while.”

Some new experiences yield funny stories. She mentioned “an origami class that went terribly and a dancing class that didn’t go well,” and yet recalled them with equanimity. Another time, she signed up for a silent retreat, despite her worry that a weekend where “people didn’t talk” could end up being intolerable. Maura promised herself that, if it were terrible, she’d go home early, but she wound up enjoying it. Other first attempts have included taking a solo trip to Philadelphia, soaking in a sensory deprivation tank, getting an aromatherapy wrap, going on a daytrip to The Cloisters organized by the Smithsonian Institution, joining a meet-up group of classical music fans, and becoming a Toastmaster.

About her commitment to new experiences, Maura asserted that this is how a person can “build a more expansive life for yourself. Because if you do something new and you enjoy it, then you can continue to do it, adding it to your regular activities. So it kind of builds on itself.” Maura’s regular activities include going for long walks (and occasionally taking pictures of what she sees for her Pinterest board), listening to live music, especially jazz and classical music, meditating, and attending Toastmasters.

Shifts in social relationships

It’s one thing to modify one’s own behavior; it’s another, more complex challenge to change it in the context of social relationships and pressures to join in the eating, drinking, and merry-making habits of one’s friends and family. Maura explained, “To go on a liquid weight loss plan and closely monitor the amount of food that you eat really requires a lot of focus on yourself, a very conscious effort… It can feel like a very selfish act if you’re not used to doing that.” In the health changes she has made, Maura has had to carefully think about “who is supportive of that type of change.”

Friendships and acquaintanceships have been affected since Maura embarked on a weight loss and maintenance program. “Some people would make negative remarks about my eating habits and my shrinking body; the changes seemed to make them anxious, at least that was my perception. Others were a little hurt.” As she steered away from occasions for going out to meals or happy hour with friends or co-workers, “I felt as though I was creating distance between us. However, most people were accepting, but it did require some re-adjusting.” Some relationships may fade into the background while others become more important. New friendships also bloom. Maura said:

“People may surprise you who come into your life, or take a bigger role in your life. If you become more interested in fitness, maybe you’ll meet people who are also interested in that. As your focus changes in terms of your health, that can change even your relationships with the people that you have in your life, and it may bring some new people into it.”

Socializing at work has its own set of challenges. As a person with diabetes, I myself have noticed the prevalence of free food in the work place. Co-workers bake cakes and bring it in to share; candy dishes sit on reception desks; and attendance at meetings is in part provoked by the promise of lunch or an afternoon snack. Maura mentioned the personal events celebrated in her office and its effect on her interactions with her co-workers:

“They’re having a birthday, or a shower, or that sort of thing. There’s frequently a cake in the office and a party. It’s hard because I don’t feel like I can stay there for a long time at these parties because all the temptation is there, all these things that I shouldn’t have. I make an appearance with my Diet Coke. They bring in this wonderful cake that they’ve made, and it’s like “you don’t want a piece of that?” I usually I nibble on something and leave. You have to say no. People can take that very personally.”

Maura added that, when the culture equates food with love, people can feel rejected when we reject the food they’ve brought. To the person on the diet, it feels “very clear cut,” said Maura, but it causes some unhappiness for the food giver. She worries about “coming across as a curmudgeon.” Because she feels some social anxiety about this, her usual strategy is to make an appearance for a few minutes, put on her coat, and take a walk, which gets her some exercise and alleviates the anxiety about not attending the full party.

The discomfort that came with setting new boundaries for relationships arose as Maura recognized that, in her family and at work, she often played the role of reliable support person. She believes she is not unique. “The biggest misconception out there is that overweight people are lazy and self-indulgent. And the one thing I know about the overweight people that I’ve met over the years is that usually they are the rock, the go-to person.” Putting others’ needs first – “and putting one’s self last,” as Maura told me – may even contribute to weight or health problems.

Maura reminds herself that, because of her health issues, it’s really necessary to re-focus energy on herself. This ultimately has benefits for the people in her life: “If I’m not around anymore because I let my health go again, I won’t be there to help the people on my to-do list.”

Relapses, and a recommitment to health

Losing a significant amount of weight and keeping it off for years has not always been a straightforward path of continual improvement. Maura admitted to lapses. For her, this involves eating “off plan.” She goes out to eat with friends and has more than she plans to eat. As a one-time event, this does not interfere with staying on her plan. However, when it happens over time, she starts to feel it:

“I can get caught up in what is called emotional eating. Perhaps I’m going through a lot of stress, some kind of difficulty, and I use food as a way to distract myself from my problems. Unfortunately, it doesn’t really help a person. It just distracts you so that you really just end up kicking the can down the road instead of dealing with your problems.”

Not feeling well or like herself – sluggish, even having trouble walking up stairs – alerts Maura that she’s off track. When she gains weight, she realizes she has taken her eye off the issue. The palpable memory of feeling good is, Maura said, “something that I want to feel again.” The desire to regain her strength and well-being is a powerful motivator that prods her to recommit to her plan, be aware of food choices and portions, and exercise daily.

She also gets energy from talking to others about challenges to maintain her weight and fitness levels. At the National Center for Weight and Wellness, she participates in a support group and sincerely enjoys talking about these issues:

“When I talk to other people who are struggling, people may think, “Well, that’s great. She’s helping me,” but I always feel like I help myself when I get into those conversations with people. Really, it does re-energize me. I get a lot of great ideas. People are just so thoughtful about how they think about their weight and their health. I’m always getting a different perspective.”

Maura expressed an interest in talking about health “beyond the clinic.” While a specific plan has not yet crystallized, she has sensed that “a lot of people who have weight problems don’t or can’t really envision what it can be like for them.” She acknowledged that her weight and health once felt “hopeless” to her.

Even though she can recognize her achievement, Maura believes she will never be home free. “I feel physically different, but the weight will always be an issue for me – a concern for the rest of my life.” Maura would like to share that message with others who are trying to summon up the bravery and resources to face a big health challenge: “You can have these health issues yet still have a different outcome than the one you have presently, and a different lifestyle.” She insisted, “There are possibilities in our lives.”

The Diabetes Media Foundation (DMF) is a 501(c)(3) tax-exempt nonprofit media organization, registered in New York and the IRS, under EIN #46-3338815. DMF is devoted to informing, educating, and generating community around, living a healthy life with diabetes.